sedation and driving

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I work in an endoscopy unit in Wisconsin. We have been going around and around on the issue of needing drivers for any patient being sedated. Although our instructions clearly state that this is needed, there's always those few who insist that there is no one in the world who they can call. We had been allowing these folks to take a cab after we kept them a little longer in recovery but, we really need to turn over our beds - besides, we use fentanyl and versed and the half life is many hours so we're not really helping by keeping them 1 hour extra. Do you tell these people who have prepped for a colonoscopy that they'll have to reschedule unless they come up with a driver in the next 15 minutes? We feel like we have to clamp down for safety's sake. we do follow-up calls the day after our scopes and there are maybe 2-5% who have little recollection of the day after they left us; one even blamed us when he took a cab and over-tipped the driver since he wasn't thinking straight. Then there's those who want to meet their driver at the door which gives them the chance to sneak off to their own car! How strict are your policies on driving?

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As a pt., I was told I would be rescheduled when I said that I would have to take a cab. This was strictly against policy. A driver was needed to see the pt home. DH had to resched his surg. day to be my driver. (I was not about to redo the prep again.)

SJ

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Specializes in Critical Care.

As a result of a lawsuit (of course):

Hospital Policy:

If a patient is to be discharged from any hospital service (ER/IP/OP) after they receive any narcotic any time that day, they are to have a driver.

Said driver is to be verified prior to giving said narcotic.

Nursing staff must ensure that patient is d/c'd in the passenger side of vehicle with driver present and if nursing cannot do this; security will.

Driver's name and relationship to pt will be recorded in discharge paperwork.

It is explained to our patients that this is not only to prevent them from breaking the law by DUI, it is because they need someone to help them until they recover. We point out it should be somebody they TRUST. If nobody is available to help, you cannot be discharged under the influence, period.

It's not about how to get them home; it's about the whole not remembering the day and what kind of liability the hospital can be under for adverse outcomes during ANY part of the hospital's induced "trip".

Thinking about it in terms of how to get them home is too narrow a focus.

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Specializes in ER, ICU, L&D, OR.

Post sedation and driving, should never be allowed, and I also dont like relegating them to a taxi driver either.

But nowadays you also realize people are driving while using duragesic patches, methadone, stadol, all sorts of benzodiazepines and other mind altering and mood affecting medications. And their Doctors are telling them that this is perfectly alright. In fact at any given point, there are more drivers under the influence of legally prescribed drugs driving than there are alcohol intoxicated drivers. Scares the heck out of me.

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Noone receiving sedation should be allowed to drive home. Our patients are told they are not to drive for 12 hours. If they don't have a driver we allow them to use a delivery service that charges $15.00 each way and will walk them to the door and make sure they get in okay. It's not ideal but it's better than putting them in a cab that will just drop them off at the curb.

I have seen an obnoxious, type A control freak get outside and put his hand out to his wife who handed him the keys and they got into separate cars and drove away. It was awfully tempting to take down his license plate number and call the police to report him driving under the influence!! :angryfire

I've also been read the riot act by a physician-patient who was incensed that she could not drive for 12 hours. She was told that she would need a driver but was not told that she couldn't drive all day and we were screwing up her plans for the day!! :uhoh3:

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Specializes in Community Health Nurse.

I had a colonoscopy last summer. I was told that someone had to be present during the procedure as well as drive me home. If this was not the case, the procedure would have to be rescheduled. One of my adult daughters accompanied me to the hospital, stayed the entire time, then drove me home after the procedure. I was wheeled to the passenger side of her car and assisted into the car. Once home, my daughter saw me safely into my home before she left. I slept the rest of the day away. Best sleep ever. :rotfl: That Fentanyl and Versed is some awesome stuff alright. :rotfl:

There was absolutely nooooooooo way I could have driven myself home. I was much too groggy. No one should attempt this. :nono: It is NOT safe!

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